Nonoperative treatment of insertional Achilles tendinopathy: a systematic review

• Published in: Journal of orthopaedic surgery and research Vol. 16; no. 1; p. 233
• Main Authors: Zhi, Xiaosong, Liu, Xinyuan, Han, Jing, Xiang, Yang, Wu, Helin, Wei, Shijun, Xu, Feng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.03.2021; BioMed Central; BMC
• Subjects: Bias; Insertional Achilles tendinopathy; Nonoperative treatment; Online databases; Orthopedics; Pain; Patient satisfaction; Systematic Review; Tendons; United Kingdom; Insertional Achilles tendinopathy; Systematic review; Nonoperative treatment
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-021-02370-0

Insertional Achilles tendinopathy is difficult to manage, and there is no definite consensus on which nonoperative treatment is superior over the others. We aim to provide a clear summary of the best available evidence for nonoperative treatment specific to insertional Achilles tendinopathy. Literatures were searched in PubMed, Embase, and Web of Science databases from inception to October 2020. The results were evaluated independently by two reviewers and assessed against the inclusion/exclusion criteria. All included articles were assessed for methodological quality, and study characteristics were extracted. Twenty-three studies (containing 35 groups) were eligible for the final review. The treatments included eccentric training, extracorporeal shockwave therapy (ESWT), injections, and combined treatment. Visual analog scale (VAS), Victorian Institute of Sport Assessment-Achilles questionnaire, AOFAS, satisfaction rate, and other scales were used to assess the clinical outcome. Current evidence for nonoperative treatment specific for insertional Achilles tendinopathy favors ESWT or the combined treatment of ESWT plus eccentric exercises.